June 2017

June 01, 2017

[2]Charlene Chisema, a community mobilization officer, conducts an Education Through Listening session on antenatal care.Photo credit: Amelie Sow-Dia

It is early afternoon in the village of Kanjuwale at the foot of Nguluyanawambe Mountain in central Malawi. Charlene Chisema, a community mobilization officer, asks a group of local women about best antenatal care (ANC) practices.

“It should start early – in the first months,” said one woman.

“You need four visits,” said another.

“Great!” said Chisema, who works with the Organized Network of Services for Everyone’s (ONSE) Health Activity. “How many ANC visits did you all have during your last pregnancy?”

Silence.

Suddenly, a frail woman with a baby on her lap stood up, wiped a tear from her face, and said, “I will not return to ANC.”

The women looked shocked – they were not used to such candid talk.

“Thank you for being honest,” said Chisema, leaning forward with an encouraging smile. “Please tell us why.”

Health Systems Strengthening in the Spotlight at the 70th World Health Assembly [7]

Health Systems Strengthening [4]

Universal Health Coverage [8]

US Global Health Policy [9]

Women & Gender [5]

[7]MSH Delegation: Matthew Martin, Crystal Lander, Catharine Taylor, Marian Wentworth, Stuart Knight, Barbara Ayotte, and Alison Corbacio

As the Trump Administration released its truncated global health budget [10] last week, ministers of health, members of civil society and the private sector, and government delegations met in Geneva for the annual World Health Assembly to discuss programs that exemplify the value of foreign assistance and its tangible effect on families in some of the poorest countries. In advance of the meeting, MSH released position statements [11] on WHA agenda items. Dozens of governments led by Germany and South Africa, signed the Global Compact for Universal Health Coverage 2030 [12] committing to make affordable and quality healthcare accessible for all. This year’s WHA was particularly historic with the nomination [13] of the WHO’s first African Director-General, Dr.

What’s the ROI on investing in health systems? [15]

Francis Aboagye-Nyame [16]

© 2013 Alfredo L Fort, Courtesy of Photoshare}

You can’t put a price tag on health, but we do have budgets that determine what we can spend to help countries improve their health. At Systems for Improved Access to Pharmaceuticals and Services (SIAPS)-- a USAID-funded, MSH-led program-- that means we need to look closely at the impact each dollar we spend has on achieving our goal: strengthening the management of essential medicines and supplies so they reach the people who need them and are used rationally. Here are some of the evidence-driven activities SIAPS has been pursuing, with their results.

Increasing global health security

As Bill Gates recently noted, foreign aid keeps people safe [17] and makes the world more stable. The three countries most affected by the Ebola epidemic—Guinea, Sierra Leone, and Liberia—had weak health systems that provided little or no warning of the impending epidemic and few resources with which to fight quickly.

Special Delivery: Transporting Lifesaving Supplies to Syria [19]

Stacy Lu [20]

Fragile States [21]

Health Systems Strengthening [4]

[19]SIAPS technical advisor Alan George (standing left) conducts an inventory management exercise.Photo credit: Gashaw Shiferaw/SIAPS

Some 13.5 million people desperately require humanitarian assistance in Syria, which includes access to essential medicines and other pharmaceutical products. Managing a sound supply chain is challenging in the best of circumstances—and in a crisis like this, there are many potential pitfalls and little room for error.

That becomes clear when health workers from relief organizations talk about their work in the country. The large number of displaced persons fleeing the conflict and the unstable, dangerous conditions in Syria require a tight strategy and concerted international effort to deliver vaccines, medical products and devices, and medicines.

First, there are the painstaking tasks of procuring supplies, including negotiating prices, estimating consumption rates, and quantifying stock—all against the backdrop of a situation in flux. Items shipped across the border require a specific type of sealing and more than a year of shelf life. Stock needs to be transported and stored in temperature-controlled trucks.

Building Health Systems that Work for Mothers, Newborns and Midwives [23]

Health Systems Strengthening [4]

Women & Gender [5]

[23]A midwife in Uganda leads a group antenatal care session, an approach that can transform how quality care is delivered and experienced.Photo credit: Kate Ramsey/MSH

For many people living in poor and underserved regions – whether rural communities or growing cities – midwives are the health system.

Midwives play a vital role for women during pregnancy and childbirth, but their care expands much more than that. Midwives provide solutions that ensure girls and women have access to a comprehensive range of services promoting their right to physical and mental health. They provide family planning and reproductive health services and care for newborns and young children not only at health facilities but also in communities. They deliver the respectful and excellent quality of care that can prevent more than 80 percent [24] of all maternal deaths, stillbirths, and newborn deaths worldwide.

Reaching Women in Uganda Through Pregnancy Clubs [25]

Person-centered group antenatal care in Eastern Uganda: Reaching women through pregnancy clubs [25]

Shafia Rashid [27]

[25]Women examine cards depicting health information during a pregnancy club session in eastern Uganda.Photo: Kate Ramsey/MSH

Improving the quality of care that women experience during pregnancy, childbirth, and the postpartum period has become a major global priority. Achieving good quality care requires not only clinical improvements, but also a person-centered approach that takes into account women’s and health workers’ needs and perspectives.

In 2016, the World Health Organization (WHO) updated its antenatal care guidelines [28], calling for a positive pregnancy experience through holistic, person-centered antenatal services that provide pregnant women with emotional support and advice in addition to the standard clinical assessments.

Fighting Big Diseases with Little Computers [30]

Jordan Coriza [31]

Health Systems Strengthening [4]

[30]Photo Credit: Fabrice Duhal

How health workers use technology to combat illness

Treatments for diseases like tuberculosis (TB) and HIV are lengthy and complex. Medications need to be taken regularly and for extended periods. Interruptions come at a high cost for patients, their families, and the health systems that treat them.

Over the past several years, professionals across a range of disciplines have focused on creating solutions at all levels of the health system. From a tool that helps governments calculate the economic cost of medicine stock-outs to a piece of software that allows doctors across Ukraine to follow a patient’s complex TB treatment, technology can play a critical role in bringing solutions to scale and making significant progress in the age-old fight against deadly diseases.

Here are two examples of how MSH is helping health workers use computers to fight back.

Pandemics and the Poor [33]

Ben Oppenheim [34]
Gavin Yamey [35]

Fragile States [21]

Health Systems Strengthening [4]

This article was first published on the Brookings Institute Future Development Blog [36], found here [37].

When epidemics or pandemics hit, they usually hit the poor first and worst. We have known this for a while. The German pathologist Rudolf Virchow described this link between poverty and vulnerability to outbreaks in his 1848 study of a typhus epidemic in Upper Silesia: [38] "For there can now no longer be any doubt that such an epidemic dissemination of typhus had only been possible under the wretched conditions of life that poverty and lack of culture had created in Upper Silesia."

What we have not known, until recently, is how best to help the poor protect themselves from pandemics.

To understand why the poor are more vulnerable to epidemics and pandemics and what protections are required, we need to consider how outbreaks first start, how they spread, and how they affect individuals and societies.

Read more [33]

Links
[1] https://www.msh.org/blog/2017/06/01/encouraging-healthy-practices-among-pregnant-women-through-active-listening#comments
[2] https://www.msh.org/blog/2017/06/01/encouraging-healthy-practices-among-pregnant-women-through-active-listening
[3] https://www.msh.org/users/am%C3%A9lie-sow-dia
[4] https://www.msh.org/blog-categories/health-systems-strengthening
[5] https://www.msh.org/blog-categories/women-gender
[6] https://www.msh.org/blog/2017/06/01/health-systems-strengthening-in-the-spotlight-at-the-70th-world-health-assembly#comments
[7] https://www.msh.org/blog/2017/06/01/health-systems-strengthening-in-the-spotlight-at-the-70th-world-health-assembly
[8] https://www.msh.org/blog-categories/universal-health-coverage
[9] https://www.msh.org/blog-categories/us-global-health-policy
[10] http://www.msh.org/news-events/press-room/management-sciences-for-health-vows-to-keep-advocating-for-global-health
[11] http://www.msh.org/news-events/press-room/msh-position-statements-for-the-70th-world-health-assembly
[12] https://www.internationalhealthpartnership.net/fileadmin/uploads/ihp/Documents/About_IHP_/mgt_arrangemts___docs/UHC_Alliance/UHC2030_Global_Compact_WEB.pdf
[13] http://www.msh.org/news-events/press-room/management-sciences-for-health-welcomes-election-of-dr-tedros-adhanom
[14] https://www.msh.org/blog/2017/06/09/what%E2%80%99s-the-roi-on-investing-in-health-systems#comments
[15] https://www.msh.org/blog/2017/06/09/what%E2%80%99s-the-roi-on-investing-in-health-systems
[16] https://www.msh.org/users/francis-aboagye-nyame
[17] https://www.gatesnotes.com/Development/Foreign-Aid-Keeps-Americans-Safe?WT.mc_id=20170518171534_MayForeignAid_BG-TW&WT.tsrc=BGTW&linkId=37735975
[18] https://www.msh.org/blog/2017/06/15/special-delivery-transporting-lifesaving-supplies-to-syria#comments
[19] https://www.msh.org/blog/2017/06/15/special-delivery-transporting-lifesaving-supplies-to-syria
[20] https://www.msh.org/users/stacy-lu
[21] https://www.msh.org/blog-categories/fragile-states
[22] https://www.msh.org/blog/2017/06/20/building-health-systems-that-work-for-mothers-newborns-and-midwives#comments
[23] https://www.msh.org/blog/2017/06/20/building-health-systems-that-work-for-mothers-newborns-and-midwives
[24] http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)60790-X/abstract
[25] https://www.msh.org/blog/2017/06/20/person-centered-group-antenatal-care-in-eastern-uganda-reaching-women-through
[26] https://www.msh.org/blog/2017/06/20/person-centered-group-antenatal-care-in-eastern-uganda-reaching-women-through#comments
[27] https://www.msh.org/users/shafia-rashid
[28] http://www.who.int/reproductivehealth/news/antenatal-care/en/
[29] https://www.msh.org/blog/2017/06/21/fighting-big-diseases-with-little-computers#comments
[30] https://www.msh.org/blog/2017/06/21/fighting-big-diseases-with-little-computers
[31] https://www.msh.org/users/jordan-coriza
[32] https://www.msh.org/blog/2017/06/29/pandemics-and-the-poor#comments
[33] https://www.msh.org/blog/2017/06/29/pandemics-and-the-poor
[34] https://www.msh.org/users/ben-oppenheim
[35] https://www.msh.org/users/gavin-yamey
[36] https://www.brookings.edu/blog/future-development/
[37] https://www.brookings.edu/blog/future-development/2017/06/19/pandemics-and-the-poor/
[38] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1698167/

Encouraging Healthy Practices Among Pregnant Women through Active Listening [2]

Health Systems Strengthening in the Spotlight at the 70th World Health Assembly [7]

What’s the ROI on investing in health systems? [15]

Increasing global health security

Special Delivery: Transporting Lifesaving Supplies to Syria [19]

Building Health Systems that Work for Mothers, Newborns and Midwives [23]

Related

Person-centered group antenatal care in Eastern Uganda: Reaching women through pregnancy clubs [25]

Fighting Big Diseases with Little Computers [30]

How health workers use technology to combat illness

Pandemics and the Poor [33]